title: Smooth pursuit eye movement training promotes recovery from auditory and visual neglect: a randomized controlled study.
abstract: BACKGROUND
  No treatment for auditory neglect and no randomized controlled trial evaluating smooth pursuit eye movement therapy (SPT) for multimodal neglect are available.
  
  
  OBJECTIVE
  To compare the effects of SPT and visual scanning therapy (VST) on auditory and visual neglect in chronic stroke patients with neglect.
  
  
  METHODS
  A randomized, prospective trial was conducted. Fifty patients with left auditory and visual neglect were randomly assigned. Twenty-four patients completed SPT therapy and 21 patients VST. Five patients (4 VST, 1 SPT) were lost. Each group received 1-hour sessions of neglect therapy for 5 consecutive days totaling 5 hours. Outcome measures in visual neglect (digit cancellation, visuoperceptual- and motor line bisection, paragraph reading) and auditory neglect (auditory midline) were assessed twice before therapy, thereafter, and at 2-week follow-up. The SPT group practiced smooth pursuit eye movements while tracking stimuli moving leftward. The VST group systematically scanned the same but static stimuli. Both groups were divided into subgroups, and effects were separately investigated for mild and severe neglect.
  
  
  RESULTS
  Both groups did not differ before therapy in clinical/demographic variables or neglect severity (auditory/visual). After treatment, the SPT group showed significant and lasting improvements in all visual measures and normal performance in the auditory midline. Neither visual nor auditory neglect impairments changed significantly after VST. Moreover, the treatment effect sizes (Cohen’s d) were considerably higher for visual and auditory neglect after SPT versus VST, both for mild and severe neglect.
  
  
  CONCLUSIONS
  Repetitive contralesional, smooth pursuit training induces superior, multimodal therapeutic effects in mild and severe neglect.
authors.forename: Georg
authors.initials: G
authors.lastname: Kerkhoff
authors.forename: Stefan
authors.initials: S
authors.lastname: Reinhart
authors.forename: Wolfram
authors.initials: W
authors.lastname: Ziegler
authors.forename: Frank
authors.initials: F
authors.lastname: Artinger
authors.forename: Christian
authors.initials: C
authors.lastname: Marquardt
authors.forename: Ingo
authors.initials: I
authors.lastname: Keller
mesh_terms: D000328:Adult; D000368:Aged; D001307:Auditory Perception / Q000502:physiology*; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010468:Perceptual Disorders / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D026741:Physical Therapy Modalities; D011698:Pursuit, Smooth; D020127:Recovery of Function; D020521:Stroke / Q000150:complications / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D014796:Visual Perception / Q000502:physiology*